Bed time highs.

ivm18

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Hi,lately my 14 yr.old son bedtime levels were bit high 10-11, last night he went to bed with 10.2 reading, didn't make corrections coz he's worried of getting hypo in the middle of the night. Woke up with Bs below 6.0.
Does going to bed with high readings will cause complications? He had those blood sugar readings 4 times this month.
Thank you.x
 
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LB93

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I'm exactly the same most of the time, 10-11 isn't dangerous/concerning so aren't they worth worrying about. I imagine complications normally occur if they're constantly high (i.e. poor control) ️ x
 

novorapidboi26

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my opinion is that overnight should be a close to normal as possible........as this is a fairly large chunk of the day where no food is digesting, so a good chance to get on target....

of course many are scared to go to bed on target through fear of hypo, but if the basal is correct there should be no issues......

of course the added dimension of children and their hormones and unpredictable blood sugars makes it a bit more difficult to take the attitude I have......

4 times a month isn't bad at all in fact that's quite good.......;)
 
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Heathero

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Sounds ok if waking around 6 more insulin could result in Hypo I can understand his concern . Level is obviously reducing during the night .
 
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ann34+

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Hi,lately my 14 yr.old son bedtime levels were bit high 10-11, last night he went to bed with 10.2 reading, didn't make corrections coz he's worried of getting hypo in the middle of the night. Woke up with Bs below 6.0.
Does going to bed with high readings will cause complications? He had those blood sugar readings 4 times this month.
Thank you.x
Sounds like he has very good control overall, remember hypos are terrible and can mess up the brain for next day, and it is now thought that hypos can in themselves cause long term problems. I am on the pump and might hesitate to correct much, so unless he is on the pump maybe safer to stay as he is, but maybe he could chat with DSN, as overnight basal rates, or basal insulin if not on the pump, might have to be lowered to stop such a drop, then it might be safer to correct?
 
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ivm18

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Thanks everyone for your replies. His basal is Lantus 18 units taken every night at 9 pm. He was on pump but decided to get back on MDI again. He usually do sliding scale in his rapid insulin (apidra).
@novorapidboi26 you are right, having a blood sugar level close to normal as possible during night time is our goal, I guess this is what diabetes, you cannot have a perfect reading inspite of all the hard work all day everyday. And also like what you've said night time is huge chunk of the day and that is why I am worried that if this high readings continue will cause problem in my son's health in the long term.
Definetly will consult his endo asap.
Thanks again! x
 

ivm18

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And last night he was 12.6 at bedtime didn't make corrections and woke up with 4.8 level. It's 3 nights in a row he gone to bed with those highs. I just wanted to scream at diabetes!
 

ivm18

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Fairly okay, he usually in 5-7 levels during the day. It is just his bedtime numbers were bit crazy. x
 

slip

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Looks to me as if he needs to be in the 10s before bed so he wakes up in the 4s-5s with taking that amount of slow acting. Question is why is he around the 10s before bed? I'd think about getting the evening reading down and split dose the slow acting, he should then have a more level BS.

Just my thoughts.

All the best
 

ivm18

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Thank you for your insight.
I guess it is his supper I:C that needs some adjustments, not sure though.He test 2 hrs. after supper which is around 9 pm and he get 10-12 readings.
 

slip

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What is he normally just before supper?

If he's constantly 10-12 2hrs after supper then I would agree his ratio needs tweaking, then either reduce his basal so he doesn't dip too low early morning (but then watch for levels not creeping up during the day) or split it (which if his current basal is right should keep him on an even keel)

Or it could be his basal is running out towards the end of the day anyway, if he is getting higher readings before and after supper. again splitting the basal dose might just do the trick anyway.

Obviously speak to his DN before spliting basal dose.

I feel there should be some warning of some kind with advice from others, like you see when buying natural stone paving slabs "Due to the product being natural stone there maybe some differences in appearance and colour of said stone" - so lets just say "the boys a natural"! :woot:
 
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ivm18

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Normally before supper his levels were in the 7-7.5.
Just these past 2 weeks that we always get bedtime higs. Also maybe I think its his basal insulin causing these all, we switched from levemir to lantus recently and yeah I've noticed highs at least almost 5 times now every night.
 

Saikoudaze

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Have you or him done DAFNE? It's fantastic for teaching you what to do in situations like this. I would try decreasing the basal insulin by small amounts. It should be keeping him level overnight, not dropping his blood sugars.
 
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ivm18

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Unfortunately no , don't have DAFNE here in my country or any courses where you can learn what to do or how to deal this kind of situation.
Good thing his endo is just a phone call away when having problems with my son's condition. But as of the moment endo is on a medical convention abroad.Only can reach her thru email.
 

staffsmatt

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It looks like his long acting is running out, I have a similar issue with Lantus. Did you switch away from Levimir for a particular reason? I did try it and my levels were much better, unfortunately I had a local reaction to it so had to go back to Lantus...
 

Saikoudaze

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It's worth mentioning that lantus is licensed for once daily use, you shouldn't really split that one.
 
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ivm18

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Yes I guess it's the lantus why my son's level were on highs lately, just like tonight( its 9:13 evening here in the Phils.) his bedtime number was 9.2! Unlike when he was on levemir his level were in 7-7.5 . We had made adjustments with his I:C but regardless he has this reading again.
Anyway, we switched to Lantus because it's a bit cheaper compare to Levemir but I guess it's not worth it.